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Diagnostic performance of Transrectal ultrasound for Prostate volume estimation in Men with Benign Prostate Hyperplasia
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  • Rotimi DavidOrcid,
  • Tajudeen Badmus,
  • Abdulkadir Salako,
  • Christianah Asaleye,
  • Davies Adeloye,
  • Olubukola Fanimi,
  • Jacob Opele,
  • Adeyinka Laoye,
  • Ibrahim Akinbola,
  • Martin Igbokwe,
  • Rereloluwa Babalola,
  • Chigozie Onyeze
Rotimi David
Orcid
Obafemi Awolowo University Teaching Hospital Complex
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Tajudeen Badmus
Obafemi Awolowo University Teaching Hospital Complex
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Abdulkadir Salako
Obafemi Awolowo University Teaching Hospital Complex
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Christianah Asaleye
Obafemi Awolowo University Teaching Hospital Complex
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Davies Adeloye
The University of Edinburgh Usher Institute of Population Health Sciences and Informatics
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Olubukola Fanimi
Obafemi Awolowo University Teaching Hospital Complex
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Jacob Opele
National Center for Technology Management
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Adeyinka Laoye
Obafemi Awolowo University Teaching Hospital Complex
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Ibrahim Akinbola
Obafemi Awolowo University Teaching Hospital Complex
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Martin Igbokwe
Obafemi Awolowo University Teaching Hospital Complex
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Rereloluwa Babalola
Obafemi Awolowo University Teaching Hospital Complex
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Chigozie Onyeze
Obafemi Awolowo University Teaching Hospital Complex
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Peer review status:ACCEPTED

01 May 2020Submitted to International Journal of Clinical Practice
02 May 2020Assigned to Editor
02 May 2020Submission Checks Completed
04 May 2020Reviewer(s) Assigned
02 Jun 2020Review(s) Completed, Editorial Evaluation Pending
08 Jul 2020Editorial Decision: Accept

Abstract

Background and Aim: Despite transrectal ultrasound (TRUS) being regarded as gold-standard for prostate volume estimation, concerns have been raised in literature concerning its accuracy especially in men with above-average prostate volumes. We aimed to evaluate the performance of TRUS for prostate volume estimation in a cohort of sub-Saharan African men since they are known to have relatively large mean prostate volumes. Methods: This was a prospective study of 77 sub-Saharan African men who had open simple prostatectomy for Benign Prostate Hyperplasia (BPH). Pre-operative TRUS determined total prostate volume (TPV) and transition zone volume (TZV). Following surgical enucleation, the adenoma was weighed (EPW) and its volume (EPV) also determined by fluid displacement. TRUS was repeated six weeks post-operatively to calculate the TRUS-estimated specimen volume (TESV). Results: The mean EPV, EPW, TRUS-estimated TZV, TRUS-estimated TPV and TESV were 79.1 ± 62.9mls, 79.1 ± 62.9g, 53.3 ± 28.5mls, 93.1 ± 48.9mls and 69.9 ± 44.6mls respectively. Pearson’s correlation showed perfect relationship between EPW and EPV with no difference in their mean values (r=1.000; P<0.001). Pearson’s correlation between TRUS-estimated TPV vs EPV, TRUS-estimated TZV vs EPV, and between TESV vs EPV were 0.932, 0.865 and 0.930 respectively (p = 0.0000). TRUS significantly under-estimated the TZV and TESV by 25.8ml and 9.2ml respectively; unrelated to severity of prostate enlargement. Conclusion: TRUS underestimates prostate volume, independent of prostate size. We propose simple formulae that could be used to improve the prostate volume determination from TRUS, especially if magnetic resonance imaging is not readily available or contraindicated.